Disseminated neonatal herpes simplex virus (HSV) infection is one of the most severe neonatal infections, and can have devastating consequences without early proper treatment. However, the administration of acyclovir can often be delayed because the symptoms and signs of HSV infection are non-specific and because HSV polymerase chain reaction (PCR) results may be negative early in the course of HSV infection. We report a case of disseminated neonatal HSV infection that was diagnosed by type 1 HSV PCR on day 8 of admission. Despite delayed administration of acyclovir, the patient was cured and subsequently discharged after 30 days of admission. Fortunately, this patient was treated successfully, but delayed administration of acyclovir has the potential to lead to significant problems. Considering the seriousness of neonatal HSV infection, empirical acyclovir therapy should be considered if HSV infection is suspected.
Acyclovir ; Herpes Simplex* ; Humans ; Infant, Newborn ; Methylmethacrylates ; Polymerase Chain Reaction ; Polystyrenes ; Pregnancy Complications, Infectious ; Simplexvirus*

Background: This study aimed to evaluate traumatic stress and mental health problems associated with the prolonged coronavirus disease pandemic and to determine the differences across different age groups. Methods: A total of 1,151 individuals who visited Gwangmyeong City Mental Health Welfare Center, South Korea, or accessed the website from September 1 to December 31, 2020, were included in the study. Mental health problems such as traumatic stress (Primary Care Posttraumatic Stress Disorder Screen for the Diagnostic and Statistical Manual of Mental Disorder-5); depression (Patient Health Questionnaire-9 and Children's Depression Inventory); anxiety (Generalized Anxiety Disorder-7 and Penn State Worry Questionnaire for Children); suicide risk (P4 Screener); and demographic information were evaluated. The participants were divided into three groups based on age group: children and adolescents, adults, and the elderly. Results: The results showed that 24.7%, 20.9%, 16.8%, and 20.5% of the participants were at high-risk for traumatic stress, depression, anxiety, and suicide, respectively. The difference in the proportion of high-risk groups by age of all participants was significant for traumatic stress, depression, anxiety, and suicide risk. In particular, the percentage of high-risk groups in all areas was the highest in the adult group. Also, in most areas, the ratio of the high-risk groups for children and adolescent group was the lowest, but the suicide risk-related ratio was not (adolescent group: 20.9%, adult group: 25%, elderly group 9.3%). Conclusion These results suggest that there is a need for continued interest in the mental health of the general population even after the initial period of coronavirus disease.Additionally, this study may be helpful when considering the resilience or risk factors of mental health in a prolonged disaster situation.

Objectives: ：The coronavirus disease 2019 (COVID-19) outbreak is a global medical crisis imposing particular burden on public sector employees. The aim of this study was to investigate the psychiatric distress among public sector workers amid the COVID-19 pandemic. Methods: ：We conducted a cross-sectional study with 531 public sector workers in Gwangmyung city who completed Korean versions of the Perceived Stress Scale (PSS), Patient Health Questionnaire-9 (PHQ-9), and Impact of Event Scale-Revised-Korean (IES-R-K). Results: ：The results revealed more than moderate levels of stress (85.2%), depressive symptoms (22.2%), and posttraumatic stress symptoms (38.8%). PSS total score was significantly correlated with PHQ-9, IES-R-K total scores as well as IES-R-K subscale scores. Total scores on the PSS, PHQ-9, and IES-R-K were all inversely correlated with age. Conclusions ：COVID-19-related workers experience considerable stress and depressive symptoms, with self-rated stress correlating significantly with depression scores. Age may serve as a protective factor against oc-cupational stress and burnout. These findings highlight the need for adequate psychiatric screening and interven-tion for public sector workers.

Background: and Objective: With the advancement of cancer treatments and increased life expectancy, managing breakthrough cancer pain (BTcP) is essential to improve the quality of life for cancer patients. This study aimed to compare the major rapid onset opioids in Korea based on their characteristics and costs to determine the best option for each patient. Methods: Based on sales information from IQVIA-MIDAS, sublingual fentanyl tablet (SLF), fentanyl buccal tablet (FBT), and oral transmucosal fentanyl citrate (OTFC) were selected as the top three drugs for the treatment of BTcP in Korea, considering them the most comparable drugs. The cost and cost-pain relief ratio of the drugs for short-term (1 month) and long-term (1 year) treatment were compared and the ease of administration based on various factors, including pharmacokinetics, onset of action, and administration procedures were evaluated. Results: SLF was evaluated as the best overall in terms of rapid onset of action, ease of administration, and drug cost and also had the highest market share. SLF had the lowest cost pain relief ratio for both the initial and supplemental treatment for the 1-month pain intensity difference 15 (PID15) ratio. However, for the 1-month PID30 ratio, SLF was not superior to OTFC or FBT. The longer the breakthrough cancer pain duration, the more cost-effective the other rapid onset opioids. Conclusion The rapid onset opioids that fit the patient’s breakthrough cancer pain pattern have the best cost-effectiveness.

PURPOSE: The present study aimed to evaluate atypical lymph node metastasis rates according to tumor depth, size, and location in patients with gastric cancer.METHODS: A total of 727 gastric adenocarcinoma patients, with metastasis to 1 or 2 lymph nodes, who underwent radical gastrectomy with curative intent from May 2003 to May 2017, were enrolled in this study. The characteristics of atypical (skip or transversal) metastases were evaluated according to the following risk factors: longitudinal versus circumferential location, size, and T stage of the tumor.RESULTS: The rates of skip and transversal metastases were 8.4% and 15.5%, respectively. Skip metastases were present throughout, regardless of the primary tumor location. On the contrary, transversal metastases of gastric cancer were most frequently observed in the lower third region (19.5%, P=0.002). When the size of the tumor is large (>4 cm), transversal metastasis was found to be significantly more common (P=0.035), compared with skip metastasis, which was less common (P=0.011). There was no significant correlation between atypical metastases and tumor depth.CONCLUSION: Lower and larger tumors were more likely to have transversal metastases compared with others; however, skip metastases were less common in large tumors.
Adenocarcinoma ; Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Risk Factors ; Stomach Neoplasms

PURPOSE: We aimed to verify whether the formal clinical index derived from infants and toddlers have a good association with the disease severity when we confine subjects to only infants, who undergo profound changes physically and immunologically. METHODS: We retrospectively reviewed the medical records of hospitalized infants with acute bronchiolitis caused by respiratory syncytial virus between January 1, 2010 and December 31, 2011 in three hospitals. The age, respiratory rate, presentation of chest retraction, and percutaneous oxygen saturation upon admission; presentation of fever, use of oxygen therapy and inhaled corticosteroid within 24 hours after admission were investigated. We then examined the effect of clinical index on severity of acute bronchiolitis; the mean length of stay, mean duration of fever and oxygen therapy. RESULTS: A total of 172 infants were studied. The mean length of stay was longer in patients younger than 3 months (P=0.015), in those with fever (P=0.028) and chest retraction (P=0.014), and in those who needed oxygen supplement (P=0.000). In the patients with fever, the mean duration of fever was longer in those who needed the oxygen supplement than those who did not (P=0.046). CONCLUSION: Younger than 3 months of age, chest retraction upon admission; fever, need of oxygen supplement within 24 hours after admission may predict the severe course of infants with acute bronchiolitis.
Bronchiolitis* ; Fever ; Humans ; Infant* ; Length of Stay ; Medical Records ; Oxygen ; Respiratory Rate ; Respiratory Syncytial Viruses ; Retrospective Studies ; Thorax